title: Hyperferritinemia is associated with serologic antiphospholipid syndrome in SLE patients.
abstract: Ferritin may play a direct role on the immune system. We sought to determine if elevated levels of ferritin in lupus patients correlate with disease activity and organ involvement in a large cohort. Ferritin levels (gender and age adjusted) were assessed in 274 lupus serum samples utilizing the LIASON Ferritin automated immunoassay method. Significant disease activity was determined if European Consensus Lupus Activity Index (ECLAM)>2 or Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)>4. Utilizing an EXCEL database, we compared elevated ferritin levels to manifestations grouped by organ involvement, serology, and previous therapy. The patients were predominantly female (89%), median age was 37 years old, and disease duration was 10.6 ± 7.7 years. Hyperferritinemia was found in 18.6% of SLE patients. Compared to subjects with normal ferritin levels, a significantly greater proportion of patients with hyperferritinemia had thrombocytopenia (15.4% vs. 33.3%, p=0.003) and lupus anticoagulant (11.3% vs. 29.0%, p=0.01). Additionally, compared to normoferritinemic subjects, hyperferritinemic subjects had significantly higher total aCL (99.7 ± 369 vs. 30.9 ± 17.3 GPI, p=0.02) and aCL IgM antibody levels (75.3 ± 357.4 vs. 9.3 ± 10.3 GPI, p=0.02), and marginally lower aCL IgG antibody levels (9.2 ± 4.9 vs. 9.7 ± 3.9 GPI, p = 0.096). While the ECLAM score significantly correlated with hyperferritinemia (p=0.04), the SLEDAI score was marginally associated with hyperferritinemia (p = 0.1). Serositis was marginally associated with hyperferritinemia, but not with other manifestations. An association with serologic APS was encountered. Hyperferritinemia was associated with thrombocytopenia, lupus anticoagulant, and anti-cardiolipin antibodies suggest that it may be an early marker for secondary antiphospholipid syndrome in SLE patients.
authors.affiliation: Departments of Medicine C, Wolfson Medical Center, Tel-Aviv, Israel, goddard@wolfson.health.gov.il.
authors.forename: Gisele
authors.initials: G
authors.lastname: Zandman-Goddard
authors.forename: Hedi
authors.initials: H
authors.lastname: Orbach
authors.forename: Nancy
authors.initials: N
authors.lastname: Agmon-Levin
authors.forename: Mona
authors.initials: M
authors.lastname: Boaz
authors.forename: Howard
authors.initials: H
authors.lastname: Amital
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Szekanecz
authors.forename: Gabriella
authors.initials: G
authors.lastname: Szucs
authors.forename: Josef
authors.initials: J
authors.lastname: Rovensky
authors.forename: Emese
authors.initials: E
authors.lastname: Kiss
authors.forename: Nadia
authors.initials: N
authors.lastname: Corocher
authors.forename: Andrea
authors.initials: A
authors.lastname: Doria
authors.forename: Ljudmila
authors.initials: L
authors.lastname: Stojanovich
authors.forename: Francesca
authors.initials: F
authors.lastname: Ingegnoli
authors.forename: Pier Luigi
authors.initials: PL
authors.lastname: Meroni
authors.forename: Blaz
authors.initials: B
authors.lastname: Rozman
authors.forename: Jesus
authors.initials: J
authors.lastname: Gomez-Arbesu
authors.forename: Miri
authors.initials: M
authors.lastname: Blank
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Shoenfeld
mesh_terms: D000328:Adult; D016736:Antiphospholipid Syndrome / Q000097:blood* / Q000150:complications*; D015415:Biomarkers / Q000097:blood; D005260:Female; D005293:Ferritins / Q000097:blood* / Q000378:metabolism; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000097:blood* / Q000150:complications*; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D015415:Biomarkers; D005293:Ferritins